Provider Demographics
NPI:1679942312
Name:KEMA HAIR PASSION, INC.
Entity type:Organization
Organization Name:KEMA HAIR PASSION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:KEMA
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:HAIR LOSS SPECIALIST
Authorized Official - Phone:678-250-3392
Mailing Address - Street 1:250 LANGLEY DR
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-6940
Mailing Address - Country:US
Mailing Address - Phone:678-250-3392
Mailing Address - Fax:
Practice Address - Street 1:250 LANGLEY DR
Practice Address - Street 2:SUITE 1102
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6940
Practice Address - Country:US
Practice Address - Phone:678-467-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACO0754521744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty